NU823 Unit 9 Sustainability Plan Example

Reviewed by Elspeth Marlowe, MSN, RN DNP Project Dissemination Purdue University Global Free custom sample in 24 to 48h

This NU823 Unit 9 sample is a sustainability plan for keeping diabetic foot exams in rooming at a composite community health center once the DNP student leaves, built on Chambers, Glasgow and Stange's Dynamic Sustainability Framework. It forms part of Purdue Global NU 823, DNP Project Dissemination, within the DNP program. Two practices are named as core from the project's own data: the exam at rooming by a signed-off medical assistant, and podiatry booked before the patient leaves. Everything else is released to adapt. Six owners are proposed from existing roles, a drift rule restarts observed exams after two months below 70 percent, foreseeable changes are mapped, costs are stated, and the handover date closes it.

CourseNU823 DNP Project Dissemination
UnitUnit 9
Paper typeSustainability plan
LengthAbout 930 words, 6 pages double-spaced
FormatAPA 7 student paper
SchoolPurdue University Global
ProgramDoctor of Nursing Practice (DNP)
UpdatedOctober 2026

Free sample paper for NU823 Unit 9

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Two Things That Must Not Change and Everything That May: A Sustainability Plan Keeping Foot Checks in Rooming After the DNP Student Leaves, Built on the Dynamic Sustainability Framework, With an Owner for Each Part

[Student Name]

Purdue University Global

NU823: DNP Project Dissemination

Unit 9 Sustainability Plan

[Instructor Name]

[Date]

The health center, roles and figures are composite; thresholds and dates are bracketed, and every owner is proposed, not confirmed.

What this part is doingThe plan decides first what must not change, because the framework assumes everything else will.
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The Framework

Chambers and colleagues argued that sustainability should not mean holding an intervention fixed in the form it was tested, because practice settings, populations and evidence keep changing. Their Dynamic Sustainability Framework treats ongoing adaptation as expected and asks teams to keep learning how well the intervention fits as the setting changes (Chambers et al., 2013). For this plan, that means deciding which parts of the foot exam protocol carry the result and protecting those, while letting the site change the rest without asking permission.

The Core

Two practices are core, because the project's own data link them to its results.

1. The exam at rooming, by a medical assistant signed off on technique, for every patient flagged with an open foot-exam gap. Coverage at scheduled visits climbed from roughly [41] percent to [84] percent only after the exam moved to rooming, and the observation data showed technique held when every assistant had three signed-off exams before working alone. The standing order and the sign-off requirement are therefore part of the core.

2. A podiatry appointment booked with the patient before they leave the building, for every patient classified as high risk who does not already see a podiatrist. Referral completion within [30] days was [57] percent when referrals were placed and patients were called later, and about [81] percent after booking at checkout began.

A core that is too large becomes a rule book no one follows; a core that is too small lets the result disappear while the protocol looks intact.

What May Adapt

Everything else may change without review: the brand of monofilament or tuning fork, the format of the huddle, whether training is given in person or online, the wording medical assistants use to explain the exam, who in the clinic books the podiatry appointment, and which podiatry practice the health center partners with. The plan names these explicitly so that the clinic manager does not need to ask whether a change is allowed. Fidelity monitoring during the project treated these as delivery details rather than parts of adherence (Carroll et al., 2007), and the plan keeps that distinction.

What this part is doingReleasing named elements explicitly prevents the site from either freezing the whole protocol or changing the core by accident.
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Ownership

Each part of the protocol is proposed to the role that already controls it, so no new position or meeting is created.

1. Monthly coverage report: clinic manager, main clinic, drawing on the flowsheet extract the informatics team already produces.

2. Training and sign-off for new medical assistants: nurse educator, as part of orientation.

3. Booking podiatry before the patient leaves, and the referral log: referral coordinator.

4. Exam supplies and their yearly replacement: operations manager.

5. Flowsheet visibility in every new rooming profile: informatics lead, at each profile build, a check added after the barrier analysis found the flowsheet missing from the float profile.

6. The standing order, renewed yearly, and access to podiatry for uninsured patients: medical director.

Review and the Drift Rule

Coverage will be reviewed monthly as a standing line on the quality committee's agenda, charted weekly with the implementation-period median as the center line, [85.6] percent, using the same rules applied during the project (Perla et al., 2011). The drift rule is simple: if protocol coverage falls below [70] percent for two months in a row, or if a run chart shift below the median appears, the nurse educator restarts observed exams for one month and the clinic manager reviews the huddle flag. For referral completion, two consecutive months below [75] percent prompt a review of the booking step with the referral coordinator.

When the Setting Changes

What this part is doingForeseeable changes are matched to the part of the plan that absorbs them, so the core survives turnover and new partners.
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The framework expects changes outside the project's control, and three are already foreseeable. Staff turnover will bring medical assistants who were never trained; the sign-off requirement covers them. A change of podiatry partner could break the referral agreement; the core requires only that an appointment be booked, not with whom. And new guidance on foot risk categories may change who is referred; the provider's risk classification can follow updated guidance without changing the rooming exam (Chambers et al., 2013).

What Keeping It Costs

Keeping the core in place costs money and staff time, and the figures appear here so no owner meets them for the first time later. Protecting the exam in rooming means building roughly [three] exam minutes into the rooming standard for each eligible visit, which at current volumes is about [190] staff hours a year spread across both clinics. Supplies come to about $[850] a year once worn filaments and forks are swapped out in all [22] rooms. Booking podiatry before the patient leaves takes the referral coordinator about [ten] minutes per high-risk patient, roughly [15] hours a year. The largest unknown is access for uninsured patients, which the medical director is weighing as either a reduced-fee agreement or a subsidy. These figures match the executive summary, and the plan does not assume any of them has been approved.

Handover

The plan is proposed to each owner at a meeting with the clinic managers and medical director before the student's last day on site, [date]. No owner is described here as having accepted, and the plan becomes the site's only when they do.

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References

Carroll, C., Patterson, M., Wood, S., Booth, A., Rick, J., & Balain, S. (2007). A conceptual framework for implementation fidelity. Implementation Science, 2, Article 40. https://doi.org/10.1186/1748-5908-2-40

Chambers, D. A., Glasgow, R. E., & Stange, K. C. (2013). The dynamic sustainability framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science, 8, Article 117. https://doi.org/10.1186/1748-5908-8-117

Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality & Safety, 20(1), 46-51. https://doi.org/10.1136/bmjqs.2009.037895

NU823 Unit 9 instructions, in plain terms

Unit 9 asks what keeps the change running once you are gone from the site. Most prompts want a sustainability framework, the elements that must be kept, those that may change, an owner for each, a plan for monitoring, a response if performance slips and the resources needed. Four to six pages is common. Faculty value plans that justify the core from the project's own evidence, keep it small, and assign ownership to roles that already control each element rather than creating new positions. Review should sit in an existing meeting. A clear rule for what happens when results drift is expected, and every owner should be described as proposed until they accept. Foreseeable changes, such as staff turnover or a new partner, are worth planning for by name.

How the NU 823 Unit 9 example is put together

The plan introduces the Dynamic Sustainability Framework and its view that adaptation is expected. The core section names two practices and ties each to data: coverage climbing from 41 to 84 percent once the exam moved to rooming, and referral completion rising after booking at checkout, with the highlighted line on sizing the core. Elements free to adapt are named one by one. Ownership goes to six existing roles, including an informatics check added after the barrier analysis. Review and the drift rule set a monthly run chart, a coverage trigger and a referral trigger. Foreseeable changes, from turnover to a new podiatry partner, the yearly cost of keeping the core and the handover meeting before the student's last day close the plan.

Where the points sit in the NU823 Unit 9 rubric

Sustainability plans in NU 823 are usually assessed on use of the framework, justification of the core, ownership and monitoring, and realism about resources. Framework use earns credit when its central ideas shape the plan rather than appearing only in an opening paragraph. Core justification rewards practices tied to the project's own results and kept to a small set. Ownership and monitoring points go to plans that assign each element to an existing role, place review in a standing meeting and state a specific drift rule. Realism is judged on whether costs and staff time are stated and whether owners are described as proposed. Organization, a plan for foreseeable changes and APA 7 citation make up the remainder.

NU823 Unit 9 help: mistakes that cost points

Plans often weaken themselves by declaring the whole protocol essential, which the site cannot keep and will abandon in pieces. Another frequent gap is assigning everything to a new coordinator who does not exist. Some plans say results will be monitored without saying by whom, how often or what triggers action. Others describe owners as committed when no one has agreed. Keep the core to what your data show carries the result, release the rest by name, give each element to the role that already controls it, set a numeric drift rule tied to an existing meeting, state the costs, and mark every owner as proposed. Then name two or three changes you can already see coming and say which part of the plan absorbs each.

Get an NU823 Unit 9 example written to your instructions

Tell us which parts of your intervention you believe carry the effect, who already controls each piece locally and whichever framework your section names; include the Unit 9 prompt and rubric. Core is separated from adaptable, owners are proposed by role and a numeric drift rule is set. Free first custom sample, 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.

More NU823 papers and DNP samples

NU823 Unit 9 questions, answered

Where can I find a free NU823 Unit 9 sample paper?

This page presents the complete NU823 Unit 9 sustainability plan, covering the framework, two core practices, elements free to adapt, six owners, review and drift rules, foreseeable changes, costs and handover, with three references. A plan for keeping your own change in place is available on request.

What framework does the NU823 Unit 9 sample use?

The Dynamic Sustainability Framework published by Chambers, Glasgow and Stange in 2013, which expects interventions to keep adapting as settings change rather than holding them fixed in the form first tested.

What are the two core practices in this plan?

The foot exam at rooming by a medical assistant signed off on technique, and a podiatry appointment booked with high-risk patients before they leave the building. The project's data tie both to its results.

What is the drift rule?

If protocol coverage falls below 70 percent for two months in a row, or a run chart shift below the median appears, the nurse educator restarts observed exams for a month and the clinic manager reviews the huddle flag.

Who owns each part of a DNP sustainability plan?

The roles that already control each element. Here the clinic manager owns reporting, the nurse educator training, the referral coordinator booking, operations supplies, informatics the flowsheet and the medical director the standing order and uninsured access.